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Listeria monocytogenes (page 1)
(This chapter has 3 pages)
© 2008 Kenneth Todar, PhD

Listeria monocytogenes Transmission
EM.
Introduction
Listeria monocytogenes is a Gram-positive rod-shaped
bacterium.
It is the agent of listeriosis, a serious infection caused by
eating
food contaminated with the bacteria. Listeriosis has been
recognized as an important public health problem in the United States.
The disease affects primarily pregnant women, newborns, and adults with
weakened immune systems.
Listeriosis is a serious disease for humans; the overt form
of
the disease has a mortality greater than 25 percent. The two main
clinical
manifestations are sepsis and meningitis. Meningitis is often
complicated
by encephalitis, a pathology that is unusual for bacterial infections.
Microscopically, Listeria species appear as small,
Gram-positive
rods, which are sometimes arranged in short chains. In direct smears
they
may be coccoid, so they can be mistaken for streptococci. Longer cells
may resemble corynebacteria. Flagella are produced at room
temperature but
not at 37°C. Hemolytic activity on blood agar has been used as a
marker
to distinguish Listeria monocytogenes among other Listeria
species,
but it is not an absolutely definitive criterion. Further biochemical
characterization
may be necessary to distinguish between the different Listeria
species.
As Gram-positive,
nonsporeforming,
catalase-positive rods, the genus Listeria was classified in
the
family Corynebacteriaceae through the seventh edition of
of
Bergey's Manual. 16S rRNA cataloging studies of Stackebrandt et
al. (1983)
demonstrated
that Listeria monocytogenes was a distinct taxon within the Lactobacillus-Bacillus
branch of the bacterial phylogeny constructed by Woese (1981). In 2001,
the Famiiy Listeriaceae was
created within the expanding Order Bacillales,
which also includes Staphylococcaceae, Bacillaceae and others. Within
this
phylogeny there are six species of Listeria. The only other
genus in the family is Brochothrix.

Listeria monocytogenes Gram
Stain.
Natural Habitats of Listeria and Incidence of Disease
Until about 1960, Listeria monocytogenes was thought to be
associated
almost exclusively with infections in animals, and less frequently in
humans.
However, in subsequent years, listeriae, including the
pathogenic
species L. monocytogenes and L. ivanovii, began to be
isolated
from a variety of sources, and they are now recognized to be widely
distributed
in Nature. In addition to humans, at least 42 species of wild and
domestic
mammals and 17 avian species, including domestic and game fowl,
can
harbor listeriae. Listeria monocytogenes is reportedly carried
in
the intestinal tract of 5-10% of the human population without any
apparent
symptoms of disease. Listeriae have also been isolated from
crustaceans,
fish, oysters, ticks, and flies.
The term listeriosis encompasses a wide variety of disease
symptoms
that are similar in animals and humans. Listeria monocytogenes
causes listeriosis in animals and humans; L. ivanovii causes
the
disease in animals only, mainly sheep. Encephalitis is the most common
form of the disease in ruminant animals. In young animals, visceral or
septicemic infections often occur. Intra-uterine infection of the fetus
via the placenta frequently results in abortion in sheep and cattle.
The true incidence of listeriosis in humans is not known, because in
the average healthy adult, infections are usually asymptomatic, or at
most
produce a mild influenza-like disease. Clinical features range from
mild
influenza-like symptoms to meningitis and/or meningoencephalitis.
Illness
is most likely to occur in pregnant women, neonates, the elderly and
immunocompromised
individuals, but apparently healthy individuals may also be affected.
In
the serious (overt) form of the disease, meningitis, frequently
accompanied
by septicemia, is the most commonly encountered disease manifestation.
In pregnant women, however, even though the most usual symptom is a
mild
influenza-like illness without meningitis, infection of the fetus is
extremely
common and can lead to abortion, stillbirth, or delivery of an acutely
ill infant.
In humans, overt listeriosis following infection with L.
monocytogenes
is usually sporadic, but outbreaks of epidemic proportions have
occurred.
In 1981, there was an outbreak that involved over 100 people in Canada.
Thirty-four of the infections occurred in pregnant women, among whom
there
were nine stillbirths, 23 infants born infected, and two live healthy
births.
Among 77 non pregnant adults who developed overt disease, there was
nearly
30% mortality. The source of the outbreak was coleslaw produced by a
local
manufacturer.
In 1985, in California, 142 people developed overt listeriosis. Of
these,
93 cases were perinatal, and among the 49 cases that were in non
pregnant
individuals, 48 were immunocompromised. Thirty fetuses or newborn
infants
died and 18 adults died. The source of the bacteria was a certain brand
of "pasteurized" soft cheese that apparently had gotten contaminated
with
non pasteurized (raw) milk during the manufacturing process.
In 2002, a multistate outbreak of Listeria
monocytogenes infections
with 46 culture-confirmed cases, seven deaths, and three stillbirths or
miscarriages in eight states was linked to eating sliced turkey
deli meat. One intact food product and 25 environmental samples from a
poultry processing plant yielded L.
monocytogenes. Two environmental
isolates from floor drains were indistinguishable from that of outbreak
patient isolates, suggesting that the plant might be the source of the
outbreak.
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